Image-guided surgery influences perioperative morbidity from endoscopic sinus surgery: A systematic review and meta-analysis

Dalgorf, Dustin M., Sacks, Raymond, Wormald, Peter-John, Naidoo, Yuresh, Panizza, Ben, Uren, Brent, Brown, Chris, Curotta, John, Snidvongs, Kornkiat and Harvey, Richard J. (2013) Image-guided surgery influences perioperative morbidity from endoscopic sinus surgery: A systematic review and meta-analysis. Otolaryngology - Head and Neck Surgery, 149 1: 17-29. doi:10.1177/0194599813488519


Author Dalgorf, Dustin M.
Sacks, Raymond
Wormald, Peter-John
Naidoo, Yuresh
Panizza, Ben
Uren, Brent
Brown, Chris
Curotta, John
Snidvongs, Kornkiat
Harvey, Richard J.
Title Image-guided surgery influences perioperative morbidity from endoscopic sinus surgery: A systematic review and meta-analysis
Journal name Otolaryngology - Head and Neck Surgery   Check publisher's open access policy
ISSN 0194-5998
1097-6817
Publication date 2013-07-01
Year available 2013
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1177/0194599813488519
Volume 149
Issue 1
Start page 17
End page 29
Total pages 13
Place of publication Thousand Oaks, CA, United States
Publisher Sage Publications
Language eng
Subject 2733 Otorhinolaryngology
2746 Surgery
Formatted abstract
Objective. Although image-guided surgery (IGS) is considered a valuable tool, its impact on perioperative morbidity for endoscopic sinus surgery (ESS) remains unclear. The evidence from reported literature is systematically reviewed with meta-analysis.

Data Sources. MEDLINE (1946 to September 14, 2012, week 2) and EMBASE (1974 to September 14, 2012, week 37).

Review Methods. MEDLINE and EMBASE were searched using a search strategy for publications on IGS during ESS that reported original data on perioperative morbidity. PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines were followed. Both comparative cohort studies with non-IGS cases and case series were included. Primary outcome was major and total complications. Secondary outcomes were specific orbital and intracranial injury, major hemorrhage, ability to complete the operation, and revision surgery. The incidence of these events was defined as dichotomous variables and expressed as a risk ratio (RR) in a fixed-effects model.

Results. In total, 2586 articles fulfilled the search, producing 55 included studies. Fourteen were comparative cohorts of IGS and non-IGS sinus surgical patient populations used for meta-analysis. Among the cohorts, major complications were more common in the non-IGS group (RR = 0.48; 95% confidence interval [CI], 0.28-0.82; P = .007). Total complications were greater in the non-IGS group (RR = 0.66; 95% CI, 0.47-0.94; P = .02). All other outcomes did not reach significance on meta-analysis.

Conclusion. Contrary to current review articles on the topic of IGS use during ESS, there is evidence from published studies that the use of IGS for sinus surgery, within selected populations, is associated with a lower risk of major and total complications compared with non-IGS sinus surgery.
Keyword Endoscopic sinus surgery
Image-guided surgery
Major complications
Meta-analysis
Patient reported outcome measures
Perioperative morbidity
Systematic review
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2014 Collection
School of Medicine Publications
 
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